Acute kidney injury

Czech version

Authors: J. Vachek ^1,2; O. Zakiyanov ^1,3; Š. Bandúr ⁴; V. Tesař ¹
Authors‘ workplace: Klinika nefrologie VFN a 1. LF UK v Praze ¹; Farmakologický ústav 1. LF UK v Praze ²; Ústav lékařské biochemie a laboratorní diagnostiky VFN a 1. LF UK v Praze ³; 1. Interní klinika FN Královské Vinohrady a 3. LF UK v Praze ⁴
Published in: Kardiol Rev Int Med 2014, 16(1): 57-61
Category: Internal Medicine

Overview

Acute kidney injury is generally defined as a condition characterised by the rapid loss of the kidney's excretory function with a decline of the glomerular filtration rate and is typically diagnosed by the accumulation of the end products of nitrogen metabolism or decreased urine output, or both. It is the clinical manifestation of a number of disorders that can affect the kidney acutely. Acute kidney injury is common in hospital patients and very common in critically ill patients, and is often secondary to extrarenal causes. New diagnostic techniques including renal biomarkers may help with early diagnosis. No specific therapies have emerged that can attenuate acute kidney injury or expedite recovery; thus, treatment is supportive. Patients are given renal replacement therapy if acute kidney injury is severe and biochemical or volume‑related, or if uraemic‑ toxaemia‑related complications are of concern. Patients typically recover to dialysis independence. However, evidence suggests that patients who have had acute kidney injury are at increased risk of subsequent chronic kidney disease. In general, acute kidney injury is associated with serious and far‑ reaching consequences not only for the patient (dialysis dependence, increased morbidity and mortality), but it also has significant economic implications for the health system.

Keywords:
acute kidney injury – creatinine – diuresis – haemodialysis – treatment

Sources

1. Lameire N, Van Biesen W, Vanholder R. Acute renal failure. Lancet 2005; 365: 417–430.

2. Mehta RL, Kellum JA, Shah SV et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007; 11: R31.

3. Bellomo R, Ronco C, Kellum JA et al. Acute renal failure – definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004; 8: R204–R212.

4. Kellum JA, Bellomo R, Ronco C et al. The 3rd International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI). Int J Artif Organs 2005; 28: 441–444.

5. Uchino S, Bellomo R, Goldsmith D et al. An assessment of the RIFLE criteria for acute renal failure in hospitalized patients. Crit Care Med 2006; 34: 1913–1917.

6. Ricci Z, Cruz DN, Ronco C. Classification and staging of acute kidney injury: beyond the RIFLE and AKIN criteria. Nat Rev Nephrol 2011; 7: 201–208. doi: 10.1038/nrneph.2011.14.

7. Collins AJ, Foley RN, Chavers B et al. US Renal Data System 2013 Annual Data Report. Am J Kidney Dis 2014; 63 (1 Suppl): A7. doi: 10.1053/j.ajkd.2013.11.001.

8. Hsu CY, McCulloch CE, Fan D et al. Community-based incidence of acute renal failure. Kidney Int 2007; 72: 208–212.

9. Hsu CY, Chertow GM, McCulloch CE et al. Nonrecovery of kidney function and death after acute on chronic renal failure. Clin J Am Soc Nephrol 2009; 4: 891–898.

10. Hegarty J, Middleton RJ, Krebs M et al. Severe acute renal failure in adults: place of care, incidence and outcomes. QJM 2005; 98: 661–666.

11. Levey AS, Eckardt KU, Tsukamoto Y et al. Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 2005; 67: 2089–2100.

12. Prescott AM, Lewington A, O'Donoghue D. Acute kidney injury: top ten tips. Clin Med 2012; 12: 328–332.

13. Madyoon H, Croushore L, Weaver D et al. Use of fenoldopam to prevent radiocontrast nephropathy in high-risk patients. Catheter Cardiovasc Interv 2001; 53: 341–345.

14. McCullough PA, Wolyn R, Rocher LL et al. Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am J Med 1997; 103: 368–375.

15. Solomon RJ. Antioxidant therapy with N-acetylcysteine for contrast-induced acute kidney injury: a final nail in the coffin? Coron Artery Dis 2014; 25: 94–95.

16. Moore RD, Steinberg EP, Powe NR et al. Nephrotoxicity of high-osmolality versus low-osmolality contrast media: randomized clinical trial. Radiology 1992; 182: 649–655.

17. Pannu N, Wiebe N, Tonelli M. Prophylaxis strategies for contrast-induced nephropathy. JAMA 2006; 295: 2765–2779.

18. Zakiyanov O, Kriha V, Vachek J et al. Placental growth factor, pregnancy-associated plasma protein-A, soluble receptor for advanced glycation end products, extracellular newly identified receptor for receptor for advanced glycation end products binding protein and high mobility group box 1 levels in patients with acute kidney injury: a cross sectional study. BMC Nephrol 2013; 14: 245.

19. Druml W. Acute renal failure is not a "cute" renal failure! Intensive Care Med 2004; 30: 1886–1890.

20. Hoffmann U, Fischereder M, Krüger B et al. The value of N-acetylcysteine in the prevention of radiocontrast agent-induced nephropathy seems questionable. J Am Soc Nephrol 2004; 15: 407–410.

21. Huber W, Eckel F, Hennig M et al. Prophylaxis of contrast material-induced nephropathy in patients in intensive care: acetylcysteine, theophylline, or both? A randomized study. Radiology 2006; 239: 793–804.

22. Stacul F, van der Molen AJ, Reimer P et al. Contrast induced nephropathy: updated ESUR Contrast Media Safety Committee guidelines. Eur Radiol 2011; 21: 2527–2541. doi: 10.1007/s00330-011-2225-0.

23. Rahman MM, Haque SS, Rokeya B et al. Trimetazidine in the prevention of contrast induced nephropathy after coronary angiogram. Mymensingh Med J 2012; 21: 292–299.

24. Goldstein SL, Chawla L, Ronco C et al. Renal recovery. Crit Care 2014; 18: 301.

25. Palevsky PM, Zhang JH, O'Connor TZ et al. Intensity of renal support in critically ill patients with acute kidney injury. N Engl J Med 2008; 359: 7–20. doi: 10.1056/NEJMoa0802639.

26. Bellomo R, Cass A, Cole L et al. Intensity of continuous renal-replacement therapy in critically ill patients. N Engl J Med 2009; 361: 1627–1638. doi: 10.1056/NEJMoa0902413.

27. Thakar CV, Christianson A, Himmelfarb J et al. Acute kidney injury episodes and chronic kidney disease risk in diabetes mellitus. Clin J Am Soc Nephrol 2011; 6: 2567–2572.